Tag Archives: athletes

As the mileage builds up and the training runs get longer, the marathon is feeling real and achievable. With regular running, I’ve noticed my body is more relaxed during my long runs – I’m not in a rush to finish, and I take each distance one mile at a time, trying to enjoy the finally cooler morning air. I’m not trying to get a specific time, I’m just training my body to embrace the progressively longer distances. Running is such a mental exercise, and more than half the battle is just convincing yourself you can and will do it.

Of course, running is also physical. Deep vein thrombosis (DVT) is also physical. And the most important thing I wear every day so that I can have a clear mind and focus on my running or anything else in my life is a compression stocking.

It’s been nearly two years since I was diagnosed with DVT, but I still wear my compression stocking daily. All day. Every day. I pretty much only take it off to shower and sleep.

What is a compression stocking?

Compression stockings are a special type of stocking/sock to help promote circulation in your legs after a DVT. The stockings are graduated, which means that they start tighter in the ankle and gradually become less tight as they go up the leg. The stockings apply pressure in such a way that your blood is encouraged (squeezed!) to move out of your leg. Compression helps stop the blood from pooling in your leg, which causes much of the post-DVT swelling and pain.

Why is it important to wear one?

Depending on the severity of your DVT, you may be experiencing varying degrees of swelling, pain and residual clotting/scarring in your veins. DVTs can result in significant trauma to your veins. Arteries bring blood (oxygen) to your legs (and other body parts), and veins bring the blood back to the heart and lungs for oxygenation. Because a DVT damages your veins, and not your arteries, your blood is still able to go into your legs and provide them with oxygen.* The problem comes when your body tries to get that blood back out of your leg, via your veins.

When the valves in your legs are damaged after a DVT, the blood can flow backward in the veins and your legs will be left swollen. Compression stockings can help mitigate this effect.

In many cases, people who have experienced a DVT develop something called post-thrombotic syndrome. In a properly functioning leg, your blood moves through your veins through clear clot-free pathways with the help of valves. Valves make sure your blood keeps moving in the right direction. They support the weight of the blood in your veins and keep the blood going forward, instead of leaking backward. Valves are especially important when working against the force of gravity—in your legs, for example.

After a DVT, your veins may be completely or partially blocked off (this may or may not be permanent, depending on the individual)—this makes it difficult for the blood to go through the veins (think of it like a traffic jam for your blood) and out of your leg. Additionally, the DVT causes inflammation of the valves and can permanently damage them. This means that even if your veins become completely clear again, if your valves are damaged, you may experience pain and swelling in your leg.

*If your leg or foot is turning blue/black, you need to see a doctor immediately. This could mean that your DVT is so severe that it is preventing oxygen from getting to your extremities. When I had my DVT (a severe form called phlegmasia cerulea dolens) my foot was turning blue because it was not getting enough oxygen. I’m very lucky I didn’t lose my leg.

So what can you do?

Elevate your leg. After a long day on your feet (or even sitting in a chair for me), give your legs a break and let gravity help get all that excess blood out of your legs.

Create new veins! It may seem totally crazy, but your body is a wonderful machine and can create new veins (called collaterals). I create new veins by running regularly and I am still seeing regular improvement in my leg. I hope that one day I won’t even feel a difference between the two legs.

Wear compression stockings. By wearing compression stockings you are doing two things – (1) You are helping reduce the swelling and pain you feel today. (2) You are reducing the severity of future post-thrombotic syndrome symptoms. Post-thrombotic syndrome can develop up to two years post-DVT. And because the valves are too small to see, it’s really difficult to tell if and how much your valves have been damaged.

How long should I wear one?

All day. Every day. Seriously.

You should wear them for at least two years after your DVT to make sure you don’t develop post-thrombotic syndrome. After that, if you’re no longer experiencing pain and swelling, and you have doctor permission, there’s no need to continue wearing them.

Take them off to sleep and shower, but you’re doing yourself a favor by wearing them as much as possible. Although they can be difficult to put on, it’s really the easiest thing you can do for yourself to help aid in your recovery. Compression stockings will help with pain and swelling, which will allow you to be more active. The more active you are in daily life, and the more you’re able to exercise, and the more veins your body can create. It’s a happy cycle.

No, they’re not incredibly comfortable. Yes, they’re a pain to put on. And yes, they’re unbelievably hot and suffocating when it’s humid and in the middle of summer. But they will MAKE YOU BETTER.

But there are so many! What do I wear?

Take a deep breath. There are a lot of options, but it’s also important you get the right stocking for you.

Length. Stockings come in different lengths: (1) knee high, (2) thigh high, and (3) pantyhose (both legs). Definitely consult your doctor first to figure out which length is best for you. If your DVT was small and in your calf only, you might only need knee high. Because my DVT was so severe, I need to wear a stocking that goes all the way to the top of my thigh. Perhaps if you had DVT in both legs, you would be best suited to wear pantyhose (both legs).

Compression. Compression stockings won’t work unless they’re tight on your leg. They should be difficult to put on and feel extremely tight. Before you purchase your first compression stockings, you should consult a doctor to make sure you are properly fitted. The stockings should have a compression pressure of 35 mmHG.

Colors. Compression stockings are offered in a variety of colors ranging from white, different shades of nude, brown and black. Although they will not match your skin color exactly, you can get pretty close.

Open and Closed Toe. This is more a matter of preference and comfort level. I have a variety of both, depending on the situation (more below).

Brand. Again, this is personal preference. When you first order compression stockings, you should purchase from several different brands. Some will fit better, be more comfortable, stand up to wear and tear longer, or match your skin tone better.

*Compression stockings are also not the same thing as the white anti-embolism stockings you will be given in the hospital. I made this mistake for a month—these stocks are given to patients and have light compression to help with blood flow to help prevent blood clots, but are not what you will need to help get over your DVT.

How often should I replace them?

Every 3-6 months. Over time, the stockings lose their elasticity and ability to compress. It’s important to replace them, or there’s no point in wearing them at all. I notice that my leg tends to ache more when the stockings start to get old.

I realize this can potentially add up to be a lot of money, but look into whether your insurance will cover them. Many do.

For those of you wearing thigh high compression stockings, you can also recycle them for your good leg (see below).

But they’re so ugly!

Yes and no. When I was first told I would need to wear compression stockings for a minimum of TWO YEARS, possibly for the rest of my life, I was pretty upset. I was convinced I would look completely ridiculous and everyone would stare at me and wonder who the weird girl with the one stocking was. As a twenty-something year old girl in New York City, it’s hard not to be a little vain and self-conscious sometimes.

But I wanted to get better, and at the end of the day my health was and is more important than any feelings of embarrassment I might have.

And you know what?

It doesn’t matter. No one cares. In fact, most people don’t even notice. And even if they do notice, they still don’t care. It’s just a sock.

But I do have some practical advice for making stockings work for you:

Rocking the single compression stocking look. Most people can’t even tell I’m wearing one.

Daily life: Most of the time, I wear a simple nude compression stocking. I prefer the open toe stocking, and pull it up over my ankle so that my leg is covered, but most of my foot is exposed. I can wear sandals and flip flops, get a manicure, walk around barefoot, all with no problem because my feet are out in the open.

Winter: If I’m wearing a skirt or a dress in the winter, I will typically wear closed toe black compression stockings. Although they are thicker and tighter than stockings you might buy for cheap at any store, no one else can tell by looking at them. I did find that it was difficult to find a “regular” stocking that would match the exact color for my good/right leg, and so I’ve started recycling my old stockings. Because compression socks are only good for 3-6 months, I will use the looser, older black closed toe stockings for my right leg.

Adding some color: Unfortunately there’s not a whole lot of fun color variety in the world of compression stockings. However, if you wear an open-toe nude stocking, your regular fun and colorful tights will go on top and no one will know the better.

Pants and jeans: I’ll wear open toe compression stockings with pants so that if I take my shoes or regular socks off, you’ll see a little bit of compression stocking sticking out from the bottom of my jeans, but nothing more.

Working out: When I work out and run, my feet like room to breathe. Closed toe compression stockings can get a little tight and make my feet uncomfortable, so I always wear open toe stockings when I work out.

Swimming: This is probably when I feel the most self-conscious. I wear the nude compression stocking and it’s definitely much more visible than normal because the top of the stock is visible. I’ll either wear shorts to cover up, or just rock the sock. I’m with my friends or family, and they don’t care.

Compression stocking underneath my running pants–with pants, shoes and socks on, you can’t even tell which leg has the stocking! (my left leg, right in this photo)

There’s no reason not to wear your compression stocking. Good for every occasion. 🙂

Wearing heels and going out for a night of dancing shouldn’t stop you from wearing your compression stockings.

At the end of the day—my drawers are filled with two types of socks (1) thigh high nude open toe and (2) thigh high black closed toe.

Where can I buy them?

You can buy your stockings from a variety of places, including online and in the store. The major compression stocking companies are:

I don’t endorse any brand or site over another, but I get my socks at compressionsale.com because I find they are the cheapest.

I’m still on the lookout for other sites and brands, so I’m happy to take more recommendations. I’m also interested in trying knee high compression running socks while training (over my regular thigh high), but I’m still looking into that as well.

Final thoughts.

First, you can get sunburnt through them. The stocking provides some sun protection, but I definitely was badly burned on my last beach vacation because I incorrectly thought I was safe.

And lastly, this is one of the easiest ways you can protect yourself and get better! Rock the one legged sock all the time and you can live a happier and healthier life. 🙂

Although doctors initially told me I would never be able to run again, I have since run five half marathons and numerous other races. I run regularly, and I’m convinced running saves my life daily.

DVT left the veins in my left leg a scarred and clotted mess. But running has allowed my body to heal and generate new veins (collateral veins) to help meet the demands I put on it with an active lifestyle.

I am still slower than I was two years ago, but I am determined to be better than I was before.

This is where the marathon comes in.

A marathon was something I thought impossible two years ago when I was healthy. A marathon was impossible a year and a half ago when I was in the hospital. A marathon was still impossible when I signed up. A marathon is still impossible today. But by training for and running the NYC Marathon, I want to prove to myself (and hopefully to you) that anything is possible.

I also want to use my first marathon as an opportunity to spread awareness. By sharing my story, I have already been able to warn my friends and family about the signs, symptoms and dangers of a blood clot, but I want to take this further, and I’m hoping you’ll help.

More than one person dies every six minutes from a pulmonary embolism.

That’s 274 people dying each day from a blood clot.

This is more than HIV, breast cancer and motor vehicle crashes COMBINED.

These numbers are completely crazy and should not be this high. How could these numbers be reduced? Awareness. Awareness. Awareness. If more people knew how to (1) recognize the signs and symptoms of a DVT before it was too late, and (2) take simple precautions to avoid a DVT, thousands of lives could be saved each year.

The National Blood Clot Alliance is one of the largest organizations working to help spread awareness of DVT and provide assistance to those who have experienced a DVT. Although its focus has in the past been on patient advocacy, it is refocusing its efforts on public awareness in 2015 and in the future.

TEAM STOP THE CLOT for the 2014 TCS New York City Marathon is raising money for the National Blood Clot Alliance to help support this goal. Each team member is running 26.2 miles to help raise funds and spread the word to STOP THE CLOT.

My hope is that one day DVT and PE will be as well-known as breast cancer, skin cancer, or AIDS. It is through the efforts of many hard-working volunteers as well as generous funding that these have become everyday words.

It would mean a great deal to me if you could help achieve this goal.

Because I am not running the NYC Marathon on a charity bib (I qualified by running 9 races + 1 volunteering job last year), any money I raise will be used exclusively to STOP THE CLOT. All funds will create awareness for the general public and hopefully prevent more stories like mine from occurring.

I also promise that if you donate to my campaign, I will RUN WITH YOUR NAME on my shirt during the race–this way, we will be running together. 🙂 No donation is too small, and any amount will help STOP THE CLOT.

One of the things that I find has made training for the NYC Marathon more manageable is having a good team. It’s more than just having loving friends and family encouraging you every step of the way (although of course this too is crucial). It means having someone by your side who is also having the same experiences.

Our NYC Marathon training schedule!

Lucky for me, I am not training for my marathon solo. I have a very good friend running the same training program, and she struggles with the same runs each week. We keep each other accountable, and I know that if she’s tackling the training runs with her equally hectic work schedule and personal life, then I can do it as well. We can vent to each other about how we’re sore, or about how that week’s run was much harder than the rest…

…in short, it’s that feeling of community and shared experience that make the entire experience more enjoyable. I know that I’m not alone. And I know that together, we can both finish this thing.

Similarly, one of the most important things I’ve realized through my deep vein thrombosis (DVT or blood clots) recovery is the importance of community. DVT and pulmonary embolisms (PEs or blood clots that have broken off and gone into the lungs) are actually fairly common–one person dies every six minutes from blood clots, which adds up to more deaths in America than HIV, breast cancer, and car crashes combined!

But because there are so many of us, I’m slowly realizing there are actually a number of very helpful online communities to discuss treatment options, medications, fears, recurrences of blood clots, and even running tips.

When I was first hospitalized in Malaysia and Tokyo, I felt so alone. I had heard of DVT, but I honestly knew very little. I was overwhelmed and in a foreign country, and none of my friends had ever experienced a blood clot. It was all new, and I didn’t know my options or understand what was happening. And while I spent countless hours reading different medical journals or articles explaining the science behind what was happening to my body, I wish now that I’d spent more time interacting with other people who had experienced something similar.

Reading about other people’s experiences:

(1) educates me.

Although doctors, news, and medical journals/articles have been able to explain a great deal of what is and has happened to me, it’s been incredibly helpful to hear from others who have many more years of experience. Science is continually progressing, and I’m hopeful that treatment options will continue to expand and be perfected over time.

But there’s a lot science doesn’t know. I’ve learned there are likely more genetic clotting factors than have currently been discovered. I’ve learned that the medications that work for me now may not work in the future. I’ve learned that exercise/running certainly helps in recovery, but it’s unclear how much we can push our bodies and unclear just how much this can affect post-thrombotic syndrome (chronic pain and swelling) long-term. I’ve learned that it’s unclear why some people get post-thrombotic syndrome and others don’t.

And while a community of individual experiences cannot itself provide definitive answers, it can help broaden your general awareness of potential outcomes. Knowledge gives you the power to better manage your condition.

(2) inspires me.

More importantly, I’m inspired and constantly amazed by everyone. There were so many times I struggled–struggled to stand, struggled to walk, struggled to run. But for every struggle I felt and every bit of frustration I experienced, there are a dozen more success stories. Again, I wish I had been better aware of these communities a year ago, but even now–almost two years out–I feel motivated and inspired to see my fellow Clot Busters racing triathlons, running marathons, and doing whatever else it was they were doing before they got sick.

I encourage anyone that’s struggling to do the same. It’s so easy to feel down on yourself when you can’t do what you were once able to do, but talking to others and reading success stories made me realize that if they could do it, I could too. Very little cannot be accomplished from sheer determination and continued efforts.

Here are a few of my favorite communities–

Facebook: Running after a Pulmonary EmbolismA great community of post-PE/DVT runners who post their success stories, questions, advice and latest news. Everyone is incredibly friendly and quite responsive. This is an amazing and inspiring group of people that just won’t quit and won’t take no for an answer!

CLOT BUSTERRoland Varga maintains an Athlete of the Month post, where he shares that individual’s DVT/PE story, their recovery, their advice, and their current progress/training goals. There are over six years of monthly athletes shared on this page, and there are sure to be a few that resonate with your experiences and will motivate you to keep going. He’s been kind enough to feature me for August!

Daily Strength: Deep Vein Thrombosis & Pulmonary Embolism Support GroupAnother community of clotters that offers support and comfort for those who are experiencing or have experienced a DVT/PE.

At the end of the day, it doesn’t really matter where you go to find your community. What’s important is realizing that you are not alone, and that your goal of getting back to — no, exceeding — where you used to be physically is possible!

The last week of training was a bit of a mess—I ended up having some of the worst food poisoning of my life and my training was somewhat derailed.

But the important thing is that I still managed to get in my long run on Friday morning. From everyone I’ve talked to, this is the weekly run that is absolutely essential to a successful race day. Life and work can sometimes mess up your plans to regularly run during the week, but the long run must happen no matter what. No excuses.

With plans over the next few weekends, I’m trying to adjust my schedule to do my long run on Fridays before work. It’s definitely rough while I’m doing it, but it makes the entire weekend that much better once it’s out of the way!

Although running is keeping me healthy and improving my leg, I’m also constantly running about in my life. My days are filled with work, friends, travel, etc. that always keep me on the go–but despite being busy, I am a strong proponent of taking precautions and being safe where you can.

Because my deep vein thrombosis (DVT or blood clots) was so severe, I’ve been on a whole slew of medications to thin my blood. I’m currently taking xarelto (aka rivaroxaban—I’m a huge fan, and happy to discuss with anyone in more detail) and a baby aspirin daily. The xarelto is an anticoagulant (helps to lengthen the time it takes for my blood to clot) and the aspirin is an antiplatelet (helps to prevent my blood cells from clumping together to form a blood clot).

In short, because the veins in my leg are so damaged, I am highly susceptible to developing another DVT. And as with all DVT, if a part of the clot breaks off and goes to my heart and lungs, I will develop a pulmonary embolism (PE). PEs can be instantly fatal because they can cut off blood flow into the lungs. I had several PEs when I was first diagnosed, but was lucky they were small and not fatal.

Clearly this is not an acceptable risk. I therefore take blood thinners daily, and may well be on them for the rest of my life.

But what are the risks?

While the blood thinners help prevent future blood clots and help save my life, they also prevent my blood from clotting when I’m injured.

What does this mean?

It definitely doesn’t help that I’m a klutz, but I’ve stepped on glass and bled everywhere for close to an hour. I’ve walked into a door and given myself a concussion. I’ve bumped into tables and everyday objects and ended up with massive bruises. I’ve had bloody noses in dry weather that last a completely unreasonable amount of time.

And for the most part, this isn’t a big deal. But it does mean I’m banned from a lot of physical activities. I’m not allowed to play contact sports. I’m never allowed to ski or snowboard. I’m still trying to figure out if I can SCUBA. And I’d be an idiot for playing paintball. Lucky for me, I’ve never been coordinated enough to do most sports—it’s another reason why running is so important to me. Running is no-contact and requires nothing more than putting one foot in front of the other.

The greatest risk of being on blood thinners is mass trauma. What happens if I get hit by a car? Or something falls out of a window? Or I fall off a balcony? It’s in the freak accidents that there is the most danger. All of these are accidents that would endanger anyone, but in my case I will not stop bleeding.

Unfortunately there is currently no known antidote for xarelto (some blood thinners, such as warfarin/coumadin have a known antidote, but require much more daily upkeep and effort). This may change soon, but for now the risk of uncontrollable bleeding is even more serious. It is therefore very important that should I get in an accident, the EMT or other healthcare professional immediately know my medications and condition.

That’s why I wear a medical bracelet—it lists my name, conditions, medications and emergency contact. I wear it all the time and never take it off—going out, showering, exercising, etc. Odds are it will never be used, but there’s a peace of mind knowing that I’m prepared for the worst case scenario.

I previously wore this medical bracelet, but was worried it wouldn’t catch a medical professional’s eye in an emergency.

I had previously worn a nicer looking bracelet, but it looked too similar to the LIVESTRONG bracelets that so many people wear variations of today, and a former EMT friend of mine let me know that he would not recognize it to be a medical alert bracelet.

And so I’m sticking to the clunky big metal bracelet with the giant red medical alert notice. It’s not pretty, but in an emergency situation where every second counts, you want it to be easily recognizable.

Hopefully (probably) I will never need it. For those of you who are also on blood thinners, I highly recommend you wear one as well. We’ve already cheated death once, and there’s no reason for us to do it again—better safe than sorry!

On Thursday nights (work permitting!) we try to make it to Central Park for our weekly running class with New York Road Runners. It’s intense and often reminds me of high school track—lots of drills and exercises, always pushing us to our max.

Each week is a surprise—sprints? hills? half-mile intervals? Each week we push ourselves further than we would have on our own. Each week we run until we feel like we can’t go anymore, and then we run a little more.

I’m always dead last in this class (not an exaggeration), but I never regret going. Through the pain and heaving breathing, I know I’m getting a little stronger and a little faster. I know my heart is becoming more efficient at pumping oxygen through my body, and that my body is making new veins and clearing the clots in the old.

But what I hadn’t realized until recently is that although running is saving my life, long-distance running can also increases your odds of blood clots.

When most people think of deep vein thrombosis (DVT or blood clots), they picture the elderly or overweight. It’s hard to imagine the young or active getting sick or suddenly dying.

What many people don’t realize is that runners and other endurance athletes (and not just professionals!) are particularly prone to getting DVT. Although they combat some of the risk factors by being active and in generally good health, according to AirHealth.org, 85% of air travel DVT victims are athletic, endurance athletes like marathoners. 83% of athlete victims on planes are under 60 years.

So why is this? Endurance runners and athletes have their own set of risk factors in addition to those that apply generally.*

Dehydration. Prolonged periods of exercise can lead to dehydration, which leads to thicker blood. When your blood is thicker, it is more likely to clot. Caffeine and alcohol are also diuretics that can in turn thicken your blood.

Lower Heart Rate. A lower heart rate means your blood is moving through your body at a slower rate. When your blood moves slowly, it is more likely to clot.

Soreness and Injury. When your body experiences trauma, it may begin to form a clot at the site. Additionally, if you break a bone or strain a muscle, you may be required to wear a brace or a cast—these limit your mobility, and increase your chance of clotting.

Travel. Many athletes travel for games and races. If you travel long distances and are immobile in a car or plane, your blood can pool in your legs and form a clot.

Physical Abnormalities. There are also some physiological abnormalities that compress one of the deep veins and with repeated trauma/use, can eventually lead to a DVT. See more about Thoracic Outlet Obstruction for DVT in the arm, or May-Thurner Syndrome for DVT in the left leg.